Stereotactic radiosurgery of residual or recurrent craniopharyngioma

New treatment concept using leksell gamma knife model C with automatic positioning system

Shoji Yomo, Motohiro Hayashi, Mikhail Chernov, Noriko Tamura, Masahiro Izawa, Yoshikazu Okada, Tomokatsu Hori, Hiroshi Iseki

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background/Aims: The present study analyzed the initial experience with the application of the original concept of 'robotic microradiosurgery' using Leksell Gamma Knife Model C with automatic positioning system for management of craniopharyngiomas. Methods: Eighteen patients with residual or recurrent craniopharyngiomas underwent radiosurgery with the use of multiple isocenters, mainly of smaller size, which were positioned compactly within the border of the lesion with resultant improved dose homogeneity, increased average dose within the target, and sharp dose fall outside the treated volume. Treatment planning was mainly guided by constructive interference in steady state images with and without gadolinium enhancement. Mean tumor volume was 1.8 cm3. In 12 cases the anterior visual pathways were either compressed or attached to the lesion. The average number of isocenters was 8.7 per cubic centimeter of target volume. Mean marginal irradiation dose was 11.6 Gy. Mean maximal dose to the anterior visual pathways was 8.4 Gy. Mean follow-up was 26.8 months, and median follow-up was 24 months. Results: Tumor growth was controlled in 17 cases (94%), and its volume reduction was attained in 13 cases (72%). In 3 patients significant shrinkage of the neoplasm after radiosurgery was accompanied by improvement of the visual functions. Their impairment was not marked in any case, nor was there any new endocrinopathy. Conclusion: Application of robotic microradiosurgery to the management of residual and recurrent craniopharyngiomas showed promising results during short- to intermediate-term follow-up, providing early tumor shrinkage in the majority of cases as well as sparing of visual and pituitary functions.

Original languageEnglish
Pages (from-to)360-367
Number of pages8
JournalStereotactic and Functional Neurosurgery
Volume87
Issue number6
DOIs
Publication statusPublished - 2009 Nov
Externally publishedYes

Fingerprint

Craniopharyngioma
Radiosurgery
Visual Pathways
Robotics
Neoplasms
Gadolinium
Tumor Burden
Therapeutics
Growth

Keywords

  • Automatic positioning system
  • Craniopharyngioma
  • Gamma knife radiosurgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Stereotactic radiosurgery of residual or recurrent craniopharyngioma : New treatment concept using leksell gamma knife model C with automatic positioning system. / Yomo, Shoji; Hayashi, Motohiro; Chernov, Mikhail; Tamura, Noriko; Izawa, Masahiro; Okada, Yoshikazu; Hori, Tomokatsu; Iseki, Hiroshi.

In: Stereotactic and Functional Neurosurgery, Vol. 87, No. 6, 11.2009, p. 360-367.

Research output: Contribution to journalArticle

Yomo, Shoji ; Hayashi, Motohiro ; Chernov, Mikhail ; Tamura, Noriko ; Izawa, Masahiro ; Okada, Yoshikazu ; Hori, Tomokatsu ; Iseki, Hiroshi. / Stereotactic radiosurgery of residual or recurrent craniopharyngioma : New treatment concept using leksell gamma knife model C with automatic positioning system. In: Stereotactic and Functional Neurosurgery. 2009 ; Vol. 87, No. 6. pp. 360-367.
@article{866fe01fd2ba4e0ebeed30eb0c96d9d7,
title = "Stereotactic radiosurgery of residual or recurrent craniopharyngioma: New treatment concept using leksell gamma knife model C with automatic positioning system",
abstract = "Background/Aims: The present study analyzed the initial experience with the application of the original concept of 'robotic microradiosurgery' using Leksell Gamma Knife Model C with automatic positioning system for management of craniopharyngiomas. Methods: Eighteen patients with residual or recurrent craniopharyngiomas underwent radiosurgery with the use of multiple isocenters, mainly of smaller size, which were positioned compactly within the border of the lesion with resultant improved dose homogeneity, increased average dose within the target, and sharp dose fall outside the treated volume. Treatment planning was mainly guided by constructive interference in steady state images with and without gadolinium enhancement. Mean tumor volume was 1.8 cm3. In 12 cases the anterior visual pathways were either compressed or attached to the lesion. The average number of isocenters was 8.7 per cubic centimeter of target volume. Mean marginal irradiation dose was 11.6 Gy. Mean maximal dose to the anterior visual pathways was 8.4 Gy. Mean follow-up was 26.8 months, and median follow-up was 24 months. Results: Tumor growth was controlled in 17 cases (94{\%}), and its volume reduction was attained in 13 cases (72{\%}). In 3 patients significant shrinkage of the neoplasm after radiosurgery was accompanied by improvement of the visual functions. Their impairment was not marked in any case, nor was there any new endocrinopathy. Conclusion: Application of robotic microradiosurgery to the management of residual and recurrent craniopharyngiomas showed promising results during short- to intermediate-term follow-up, providing early tumor shrinkage in the majority of cases as well as sparing of visual and pituitary functions.",
keywords = "Automatic positioning system, Craniopharyngioma, Gamma knife radiosurgery",
author = "Shoji Yomo and Motohiro Hayashi and Mikhail Chernov and Noriko Tamura and Masahiro Izawa and Yoshikazu Okada and Tomokatsu Hori and Hiroshi Iseki",
year = "2009",
month = "11",
doi = "10.1159/000236370",
language = "English",
volume = "87",
pages = "360--367",
journal = "Stereotactic and Functional Neurosurgery",
issn = "1011-6125",
publisher = "S. Karger AG",
number = "6",

}

TY - JOUR

T1 - Stereotactic radiosurgery of residual or recurrent craniopharyngioma

T2 - New treatment concept using leksell gamma knife model C with automatic positioning system

AU - Yomo, Shoji

AU - Hayashi, Motohiro

AU - Chernov, Mikhail

AU - Tamura, Noriko

AU - Izawa, Masahiro

AU - Okada, Yoshikazu

AU - Hori, Tomokatsu

AU - Iseki, Hiroshi

PY - 2009/11

Y1 - 2009/11

N2 - Background/Aims: The present study analyzed the initial experience with the application of the original concept of 'robotic microradiosurgery' using Leksell Gamma Knife Model C with automatic positioning system for management of craniopharyngiomas. Methods: Eighteen patients with residual or recurrent craniopharyngiomas underwent radiosurgery with the use of multiple isocenters, mainly of smaller size, which were positioned compactly within the border of the lesion with resultant improved dose homogeneity, increased average dose within the target, and sharp dose fall outside the treated volume. Treatment planning was mainly guided by constructive interference in steady state images with and without gadolinium enhancement. Mean tumor volume was 1.8 cm3. In 12 cases the anterior visual pathways were either compressed or attached to the lesion. The average number of isocenters was 8.7 per cubic centimeter of target volume. Mean marginal irradiation dose was 11.6 Gy. Mean maximal dose to the anterior visual pathways was 8.4 Gy. Mean follow-up was 26.8 months, and median follow-up was 24 months. Results: Tumor growth was controlled in 17 cases (94%), and its volume reduction was attained in 13 cases (72%). In 3 patients significant shrinkage of the neoplasm after radiosurgery was accompanied by improvement of the visual functions. Their impairment was not marked in any case, nor was there any new endocrinopathy. Conclusion: Application of robotic microradiosurgery to the management of residual and recurrent craniopharyngiomas showed promising results during short- to intermediate-term follow-up, providing early tumor shrinkage in the majority of cases as well as sparing of visual and pituitary functions.

AB - Background/Aims: The present study analyzed the initial experience with the application of the original concept of 'robotic microradiosurgery' using Leksell Gamma Knife Model C with automatic positioning system for management of craniopharyngiomas. Methods: Eighteen patients with residual or recurrent craniopharyngiomas underwent radiosurgery with the use of multiple isocenters, mainly of smaller size, which were positioned compactly within the border of the lesion with resultant improved dose homogeneity, increased average dose within the target, and sharp dose fall outside the treated volume. Treatment planning was mainly guided by constructive interference in steady state images with and without gadolinium enhancement. Mean tumor volume was 1.8 cm3. In 12 cases the anterior visual pathways were either compressed or attached to the lesion. The average number of isocenters was 8.7 per cubic centimeter of target volume. Mean marginal irradiation dose was 11.6 Gy. Mean maximal dose to the anterior visual pathways was 8.4 Gy. Mean follow-up was 26.8 months, and median follow-up was 24 months. Results: Tumor growth was controlled in 17 cases (94%), and its volume reduction was attained in 13 cases (72%). In 3 patients significant shrinkage of the neoplasm after radiosurgery was accompanied by improvement of the visual functions. Their impairment was not marked in any case, nor was there any new endocrinopathy. Conclusion: Application of robotic microradiosurgery to the management of residual and recurrent craniopharyngiomas showed promising results during short- to intermediate-term follow-up, providing early tumor shrinkage in the majority of cases as well as sparing of visual and pituitary functions.

KW - Automatic positioning system

KW - Craniopharyngioma

KW - Gamma knife radiosurgery

UR - http://www.scopus.com/inward/record.url?scp=70049110024&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70049110024&partnerID=8YFLogxK

U2 - 10.1159/000236370

DO - 10.1159/000236370

M3 - Article

VL - 87

SP - 360

EP - 367

JO - Stereotactic and Functional Neurosurgery

JF - Stereotactic and Functional Neurosurgery

SN - 1011-6125

IS - 6

ER -